A patient with no known drug allergies is receiving amoxicillin ...

[viki]

A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg.
 
  What will the nurse do?
  a. Contact the provider and prepare to administer epinephrine.
  b. Notify the provider if the patient develops a rash.
  c. Request an order for a skin test to evaluate possible PCN allergy.
  d. Withhold the next dose until symptoms subside.

Question 2

A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin.
 
  The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss:
  a. adding an aminoglycoside.
  b. changing to penicillin G.
  c. reducing the dose of piperacillin.
  d. ordering nafcillin.

[underwood14]

Answer to Question 1

ANS: A
This patient is showing signs of an immediate penicillin allergy, that is, one that occurs within 2 to 30 minutes after administration of the drug. The patient is showing signs of anaphylaxis, which include laryngeal edema, bronchoconstriction, and hypotension; these must be treated with epinephrine. This is an emergency, and the provider must be notified immediately, not when other symptoms develop. It is not necessary to order skin testing. The patient must be treated immediately, and subsequent doses should not be given.

Answer to Question 2

ANS: C
Patients with renal impairment should receive lower doses of piperacillin than patients with normal renal function. Aminoglycosides are nephrotoxic. Penicillin G and nafcillin are not effective against Pseudomonas infections.

[viki]

TYSM

[softEldritch]

Gracias!